Disaster Response to a Mass Casualty Incident in a Hospital Fire by Regional Disaster Medical Assistance Team: Characteristics of Hospital Fire

2020 ◽  
pp. 1-4
Author(s):  
Jae Ho Jang ◽  
Jin-Seong Cho ◽  
Youg Su Lim ◽  
Sung Youl Hyun ◽  
Jae-Hyug Woo ◽  
...  
Keyword(s):  
Medical Records ◽  
Medical Staff ◽  
Disaster Response ◽  
Fire Department ◽  
Treatment Method ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Medical Assistance ◽  
Fire Disaster ◽  
Field Triage

ABSTRACT Objective: A disaster in the hospital is particularly serious and quite different from other ordinary disasters. This study aimed at analyzing the activity outcomes of a disaster medical assistance team (DMAT) for a fire disaster at the hospital. Methods: The data which was documented by a DMAT and emergent medical technicians of a fire department contained information about the patient’s characteristics, medical records, triage results, and the hospital which the patient was transferred from. Patients were categorized into four groups according to results of field triage using the simple triage and rapid treatment method. Results: DMAT arrived on the scene in 37 minutes. One hundred and thirty eight (138) patients were evacuated from the disaster scene. There were 25 patients (18.1%) in the Red group, 96 patients (69.6%) in the Yellow group, and 1 patient (0.7%) in the Green group. One patient died. There were 16 (11.6%) medical staff and hospital employees. The injury of the caregiver or the medical staff was more severe compared to the family protector. Conclusions: For an effective disaster-response system in hospital disasters, it is important to secure the safety of medical staff, to utilize available medical resources, to secure patients’ medical records, and to reorganize the DMAT dispatch system.

A unique hospital physician disaster response system for a nonemployed medical staff

2009 ◽  
Vol 4 (2) ◽  
pp. 95-100
Author(s):  
James D. Leo, MD, FCCP ◽  
Desiree Thomas, RN, MSN, CCRN ◽  
Ginger Alhadeff, BA, RN, MA
Keyword(s):  
Medical Staff ◽  
Disaster Response ◽  
Medical Center ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Care Needs ◽  
For Profit ◽  
Major Disaster ◽  
Physician Care ◽  
Special Challenge

Private hospitals with nonemployed, volunteer medical staffs face a special challenge in meeting the patient-care needs posed by a mass casualty incident (MCI). Although most disaster response systems focus on emergency department and trauma management, such systems often do not provide for the need to triage existing inpatients to create room for incoming casualties, for continuity of physician care for those patients, as well as for MCI victims in case of major disaster. Such systems must also provide a mechanism for ethical and appropriate rationing of limited resources during a MCI. Community hospitals without 24/7 in-house physicians must provide a mechanism for physician care for patients in situations in which access to the hospital may be limited by the disaster (eg, major earthquake or flood). This article describes a system established at Long Beach Memorial Medical Center, a 740-bed not-for-profit hospital with a volunteer medical staff, to ensure continuity of physician care in a major disaster. To our knowledge, this is the first published report of such a system.

scholarly journals (P2-26) EMS-Assessed Mass Casualty Incident: A Pilot Surveillance

2011 ◽  
Vol 26 (S1) ◽  
pp. s144-s144
Author(s):  
C.B. Park ◽  
S.D. Shin ◽  
G.J. Suh ◽  
J.O. Park ◽  
C.H. Kim
Keyword(s):  
Medical Records ◽  
Call Center ◽  
Surveillance System ◽  
Traffic Accidents ◽  
Ad Hoc ◽  
Admission Rate ◽  
Fire Department ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Overall Mortality

Background Recently the number of disaster and mass casualty incident (MCI) is increasing in Korea, but there have been few administrative reports or technical reports for disaster and MCI. An ad hoc basis data collection method is usually incomplete and outdated. This study was conducted to investigate the new surveillance system composed of EMS based real time survey and medical records based in-depth survey.MethodsA retrospective review was conducted of the 119 fire department call center database and ambulance running sheets in one metropolitan city. The data on all transported patients with non-medical reasons (fire, rescue and others) between May 2006 and December 2008 was reviewed. We selected all data from the accidents which had more than 2 casualties to exam the feasibility and conducted in-depth surveillance based on medical records.ResultsThe total number of accidents was 2,027 with 2,625 patients. The number of accidents which had more than 2 patients was 307 (total 898 patients) and more than 6 patients was 19 (total 176 patients). Among the “MCI” events, 15 cases were traffic accidents (125 patients, 71.0%), 4 cases were fire (51 patients, 29%). Total 142 medical records (80.7%) were reviewed. Admission rate was 32.4% (46 patients) and overall mortality was 3.5% (5 patients).ConclusionThis nationwide public EMS system could contribute to the establishment of the systematic disaster database.

The Tsukui (Japan) Yamayuri-en Facility Stabbing Mass-Casualty Incident

2019 ◽  
Vol 34 (02) ◽  
pp. 203-208
Author(s):  
Takaaki Maruhashi ◽  
Ichiro Takeuchi ◽  
Jun Hattori ◽  
Yuichi Kataoka ◽  
Yasushi Asari
Keyword(s):  
Emergency Surgery ◽  
Fire Department ◽  
Disabled Persons ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Fire Departments ◽  
Stab Wounds ◽  
Medical Institutions ◽  
Field Triage ◽  
Study Hospital

Introduction:In July 2016, a mass-casualty stabbing attack took place at a facility for disabled persons located in Sagamihara City (Kanagawa Prefecture, Japan). The attack resulted in 45 casualties, including 19 deaths. The study hospital dispatched physicians to the field and admitted multiple casualties. This report aimed to review the physicians’ experiences and to provide insights for the formulation of response measures for similar incidents in the future.Report:This incident involved 30 emergency teams and 12 fire department teams, including those from neighboring fire departments. Five physicians from three medical institutions, including the study hospital, entered the field. The Simple Triage and Rapid Treatment (START) method was used on the field. The final field triage category count was: 20 red, four yellow, two green, and 19 black tags. All the casualties (n = 26) except for the 19 black tag casualties were transported to one of six neighboring medical institutions.The median age of the transported casualties was 41 years (interquartile range [IQR] = 35.5 – 42.0). Three casualties (21.4%) were in hemorrhagic shock on arrival at the hospital. Twelve patients had multiple cervical stab wounds (median four wounds; IQR = 3.75 – 6.0). A total of 91.7% of these stab wounds were in mid-neck Zone II region. Of the 12 patients with cervical stab wounds, four (33.3%) required emergency surgery, and the rest were sutured on an out-patient basis. One patient had already been sutured on the field. All patients requiring emergency surgery had deep wounds, including those of the carotid vein, thyroid gland, nerves, and the trachea. Eight of the casualties were hospitalized at the study institution. Five of them were admitted to the intensive care unit. There were no deaths among the casualties transported to the hospitals.Conclusion:Regional core disaster medical hospitals must take on a central role, particularly in the case of local disasters. Horizontal communication and interactions should be reinforced by devising protocols and conducting joint training for effective inter-department collaborations on the field.Maruhashi, T, Takeuchi, I, Hattori, J, Kataoka, Y, Asari, Y. The Tsukui (Japan) Yamayuri-en facility stabbing mass-casualty incident. Prehosp Disaster Med. 2019;34(2):203–208

Is the Willingness and Ability of Nurses to Respond to Various Disasters the Same? A Cross-Sectional Study in Iran

2020 ◽  
Author(s):  
Maryam Moradi ◽  
Simintaj Sharififar ◽  
Seyyed- Javad Hosseini Shokouh
Keyword(s):  
Natural Disasters ◽  
Disaster Response ◽  
Family Health ◽  
The Elderly ◽  
Mass Casualty Incident ◽  
Cross Sectional Study ◽  
Mass Casualty ◽  
Critical Conditions ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background: Healthcare centers, as the primary organizations involved in the occurrence of unexpected events, require to identify significant and influential motivational factors in the creation of willingness and, consequently, the ability of health personnel and staff (nurses) to respond to critical situations as the main organizational assets. This study was designed with the aim to determine the factors affecting the willingness and ability of nurses to deal with various disasters in Tehran hospitals.Methods: This research is a cross-sectional study. The instrument used is a researcher-made questionnaire, which consists of three parts of demographic information, evaluation of the level of nurses' willingness and ability to respond to various disasters, and obstacles to continuing to work in disasters.Results: A total of 308 questionnaires were completed. 39.3% of participants were female, and 60.7% of them were male. The level of willingness and ability of participants to continue working in crisis indicates that the highest willingness and ability are associated with natural disasters (floods, earthquakes), and the lowest willingness and ability are related to participating in response to the disease epidemic. The prioritization of the participants in this study in connection with the most critical barriers to responding to the crisis demonstrated that caring for children in natural disasters and Mass Casualty Incident, concern for family health in chemical disasters, fear of contamination in nuclear disasters, and fear of Infection in epidemic of diseases are among the most important obstacles. In examining the factors influencing the willingness and ability of research units to participate in disaster response raised, the factors of gender, age, marital status, and health level of individuals affected the level of willingness and ability of individuals. Besides, the components of income level, care for the elderly, and care for the disabled have only been influential on the willingness of people to participate in disaster response.Conclusion: The professional preparation of health care personnel to perform their duties in critical conditions is essential. Hence, preventive measures to minimize the risk and strengthen the ethical obligations of employees in this profession in crises will be beneficial.

scholarly journals (P1-36) Mass Casualty Incident Awareness of Remote Location Staff in Western Australia

2011 ◽  
Vol 26 (S1) ◽  
pp. s110-s110
Author(s):  
R. Goswami
Keyword(s):  
Western Australia ◽  
Medical Staff ◽  
Online Survey ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Population Spread ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Remote Health ◽  
Better Than

IntroductionThe state of Western Australia has a remote population spread throughout an immense area. Remote health and retrieval is strained on a day-to-day basis, let alone in mass casualty incidents (MCIs). Anecdotally, remote medical staff has minimal training in MCI response. There is no research into how aware these staff is on principles of MCI response.MethodologyAn online survey was devised to ascertain the awareness and knowledge of medical staff most likely to be involved in a disaster. Demographic as well as questions in scenario format were disseminated to rural general practitioners (GPs), nurses and paramedics. Data was collected over a 4-month period.Results117 surveys were completed online. Analysis revealed an astute awareness of resources and environment in a potential MCI but triaging was poor and complex decision-making results were equivocal. Trained respondents handled scenarios better than experienced (MCI involvement or planning) respondents.ConclusionsIn general, remote medical staff is aware of only certain MCI principles. Further training is warranted. Voluntary feedback from these staff also strongly corroborated this view.

Field Triage and Patient Maldistribution in a Mass-Casualty Incident

2007 ◽  
Vol 22 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Richard M. Zoraster ◽  
Cathy Chidester ◽  
William Koenig
Keyword(s):  
Los Angeles ◽  
Prehospital Care ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Trauma Centers ◽  
Community Hospitals ◽  
Center Staff ◽  
Field Triage ◽  
Number Of Patients ◽  
To Receive

AbstractIntroduction:Management of mass-casualty incidents should optimize outcomes by appropriate prehospital care, and patient triage to the most capably facilities. The number of patients, the nature of injuries, transportation needs, distances, and hospital capabilities and availabilities are all factors to be considered. Patient maldistributions such as overwhelming individual facilities, or transport to facilities incapable of providing appropriate care should be avoided. This report is a critical view of the application of the START triage nomenclature in the prehospital arena following a train crash in Los Angeles County on 26 January 2005.Methods:A scheduled debriefing was held with the major fire and emergency medical services responders, Medical Alert Center staff, and hospitals to assess and review the response to the incident. Site visits were made to all of the hospitals involved. Follow-up questions were directed to emergency department staff that were on duty during the day of the incident.Results:The five Level-I Trauma Centers responded to the poll with the capacity to receive a total of 12 “Immediate” patients, 2.4 patients per center, the eight Level-II Trauma Centers responded with capacity to receive 17 “Immediate” patients, two patients per center, while the 25 closest community hospitals offered to accept 75 “Immediate” patients, three patients per hospital. These community hospitals were typically about one-half of the size of the trauma centers (average 287 beds versus 548, average 8.7 operating rooms versus 16.6). Twenty-six patients were transported to a community hospital >15 miles from the scene, while eight closer community hospitals did not receive any patients.Conclusions:The debriefing summary of this incident concluded that there were no consistently used criteria to decide ultimate destination for “Immediates”, and that they were distributed about equally between community hospitals and trauma centers.

scholarly journals Confusion, Chaos, and Bridging the Gap: A Prospective Study Gauging Disaster Triage Methodologies and Usage Across First Responder Professions

2019 ◽  
Vol 34 (s1) ◽  
pp. s111-s111
Author(s):  
Brenna Adelman
Keyword(s):  
National Policy ◽  
First Responders ◽  
The United States ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Future Research ◽  
Field Triage ◽  
Mass Casualty Event ◽  
A Prospective Study ◽  
National Trends

Introduction:Disasters are unique in that they impact all socioeconomic, class, and social divides. They are complex, hard to conceptualize and operationally define, and occur sporadically without warning. However, regardless of each disasters innate unpredictability, there is one common need that directly impacts patient morbidity and mortality: effective triage.Aim:Currently the United States has no uniform triage mandate. The purpose of this study is to gather descriptive data on the type of mass-casualty triage currently being utilized by first responders (Emergency Medical Services/Fire/Nurses) and improve our understanding regarding the prevalence of mass casualty triage.Methods:A descriptive mixed methods survey is being distributed to first responders/nurses in the Appalachian region. This survey collects respondents demographics, profession, and MCI triage data. Data will be analyzed and descriptive statistics will be generated. GIS will be utilized to graph findings and visualize local and national trends.Results:Results of this study are pending.Discussion:Organizations have addressed the need for a standard triage protocol, even going so far as to create uniform criteria which each triage system should meet. However, the literature does not describe how individual professions train their members in disaster triage, or what triage is currently being utilized in each profession. Nurses and first-responders serve as linchpins in many communities. They remain in a community, both before, during, and after a mass casualty event, but they do not perform in a vacuum. During an MCI (mass-casualty incident) their scope of practice may vary, but they have common foci: the affected community. A better understanding of the type of MCI triage that each profession is using is vital in understanding how triage is being applied, and vital in identifying gaps in application that may impact the effectiveness of field triage, and affect local and national policy, practice, and future research.

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.

Triage During Mass Gatherings

2012 ◽  
Vol 27 (6) ◽  
pp. 531-535 ◽  
Author(s):  
Sheila A. Turris ◽  
Adam Lund
Keyword(s):  
Large Scale ◽  
Scoring Systems ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Limited Resources ◽  
Mass Gathering ◽  
Publication Type ◽  
Mass Gatherings ◽  
Field Triage

AbstractTriage is a complex process and is one means for determining which patients most need access to limited resources. Triage has been studied extensively, particularly in relation to triage in overcrowded emergency departments, where individuals presenting for treatment often are competing for the available stretchers. Research also has been done in relation to the use of prehospital and field triage during mass-casualty incidents and disasters.In contrast, scant research has been done to develop and test an effective triage approach for use in mass-gathering and mass-participation events, although there is a growing body of knowledge regarding the health needs of persons attending large events. Existing triage and acuity scoring systems are suboptimal for this unique population, as these events can involve high patient presentation rates (PPR) and, occasionally, critically ill patients. Mass-gathering events are dangerous; a higher incidence of injury occurs than would be expected from general population statistics.The need for an effective triage and acuity scoring system for use during mass gatherings is clear, as these events not only create multiple patient encounters, but also have the potential to become mass-casualty incidents. Furthermore, triage during a large-scale disaster or mass-casualty incident requires that multiple, local agencies work together, necessitating a common language for triage and acuity scoring.In reviewing existing literature with regard to triage systems that might be employed for this population, it is noted that existing systems are biased toward traumatic injuries, usually ignoring mitigating factors such as alcohol and drug use and environmental exposures. Moreover, there is a substantial amount of over-triage that occurs with existing prehospital triage systems, which may lead to misallocation of limited resources. This manuscript presents a review of the available literature and proposes a triage system for use during mass gatherings that also may be used in the setting of mass-casualty incidents or disaster responses.TurrisSA, LundA. Triage during mass gatherings. Prehosp Disaster Med. 2012;27(6):1-5.

Mass-casualty Response to the Kiss Nightclub in Santa Maria, Brazil

2014 ◽  
Vol 30 (1) ◽  
pp. 93-96 ◽  
Author(s):  
Silvana T. Dal Ponte ◽  
Carlos F. D. Dornelles ◽  
Bonnie Arquilla ◽  
Christina Bloem ◽  
Patricia Roblin
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
The State ◽  
Capital City ◽  
Smoke Inhalation ◽  
Publication Type ◽  
Incident Command ◽  
Santa Maria

AbstractOn January 27, 2013, a fire at the Kiss Nightclub in Santa Maria, Brazil led to a mass-casualty incident affecting hundreds of college students. A total of 234 people died on scene, 145 were hospitalized, and another 623 people received treatment throughout the first week following the incident.1 Eight of the hospitalized people later died.1 The Military Police were the first on scene, followed by the state fire department, and then the municipal Mobile Prehospital Assistance (SAMU) ambulances. The number of victims was not communicated clearly to the various units arriving on scene, leading to insufficient rescue personnel and equipment. Incident command was established on scene, but the rescuers and police were still unable to control the chaos of multiple bystanders attempting to assist in the rescue efforts. The Municipal Sports Center (CDM) was designated as the location for dead bodies, where victim identification and communication with families occurred, as well as forensic evaluation, which determined the primary cause of death to be asphyxia. A command center was established at the Hospital de Caridade Astrogildo de Azevedo (HCAA) in Santa Maria to direct where patients should be admitted, recruit staff, and procure additional supplies, as needed. The victims suffered primarily from smoke inhalation and many required endotracheal intubation and mechanical ventilation. There was a shortage of ventilators; therefore, some had to be borrowed from local hospitals, neighboring cities, and distant areas in the state. A total of 54 patients1 were transferred to hospitals in the capital city of Porto Alegre (Brazil). The main issues with the response to the fire were scene control and communication. Areas for improvement were identified, namely the establishment of a disaster-response plan, as well as regularly scheduled training in disaster preparedness/response. These activities are the first steps to improving mass-casualty responses.Dal PonteST, DornellesCFD, ArquillaB, BloemC, RoblinP. Mass-casualty response to the Kiss Nightclub in Santa Maria, Brazil. Prehosp Disaster Med. 2015;30(1):1-4.

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