Mass Casualty Imaging—Policy, Planning, and Radiology Response to Mass Casualty Incidents

2020 ◽  
Vol 71 (3) ◽  
pp. 388-395
Author(s):  
Siobhán B. O’Neill ◽  
Brian Gibney ◽  
Michael E. O’Keeffe ◽  
Sarah Barrett ◽  
Luck Louis
Keyword(s):  
Health Care Providers ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Radiology Department ◽  
Policy Planning ◽  
Care Providers ◽  
Planning Stage ◽  
Large Numbers ◽  
Routine Procedures ◽  
Regional Hospitals

A mass casualty incident (MCI) is an event that generates more patients at one time than locally available resources can manage using routine procedures. By their nature, many of these incidents have no prior notice but result in large numbers of casualties with injuries that range in severity. They can happen anywhere and at any time and regional hospitals and health-care providers have to mount a response quickly and effectively to save as many lives as possible. Radiologists must go from passenger to pilot when it comes to MCI planning. When involved at the hospital-wide planning stage, they can offer valuable expertise on how radiology can improve triage accuracy and at what cost in terms of time and resources and thereby contribute a pragmatic understanding of radiology’s role and value during MCIs. By taking ownership of MCI planning in their own departments, radiologists can ensure that the radiology department can respond quickly and effectively to unforeseen emergencies. Well-designed radiology protocols will save lives in an MCI setting.

Comparison of Electronic Versus Manual Mass-Casualty Incident Triage

2018 ◽  
Vol 33 (3) ◽  
pp. 273-278 ◽  
Author(s):  
Claudie Bolduc ◽  
Nisreen Maghraby ◽  
Patrick Fok ◽  
The Minh Luong ◽  
Valerie Homier
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Simulated Patients ◽  
Mass Casualties ◽  
Care Providers ◽  
Manual Method ◽  
Computer Based ◽  
Triage Time

AbstractIntroductionMass-casualty incidents (MCIs) easily overwhelm a health care facility’s human and material resources through the extraordinary influx of casualties. Efficient and accurate triage of incoming casualties is a critical step in the hospital disaster response.Hypothesis/ProblemTraditionally, triage during MCIs has been manually performed using paper cards. This study investigated the use of electronic Simple Triage and Rapid Treatment (START) triage as compared to the manual method.MethodsThis observational, crossover study was performed during a live MCI simulation at an urban, Canadian, Level 1 trauma center on May 26, 2016. Health care providers (two medical doctors [MDs], two paramedics [PMs], and two registered nurses [RNs]) each triaged a total of 30 simulated patients - 15 by manual (paper-based) and 15 by electronic (computer-based) START triage. Accuracy of triage categories and time of triage were analyzed. Post-simulation, patients and participating health care providers also completed a feedback form.ResultsThere was no difference in accuracy of triage between the electronic and manual methods overall, 83% and 80% (P=1.0), between providers or between triage categories. On average, triage time using the manual method was estimated to be 8.4 seconds faster (P<.001) for PMs; and while small differences in triage times were observed for MDs and RNs, they were not significant. Data from the participant feedback survey showed that the electronic method was preferred by most health care providers. Patients had no preference for either method. However, patients perceived the computer-based method as “less personal” than the manual triage method, but they also perceived the former as “better organized.”ConclusionHospital-based electronic START triage had the same accuracy as hospital-based manual START triage, regardless of triage provider type or acuity of patient presentations. Time of triage results suggest that speed may be related to provider familiarity with a modality rather than the modality itself. Finally, according to patient and provider perceptions, electronic triage is a feasible modality for hospital triage of mass casualties. Further studies are required to assess the performance of electronic hospital triage, in the context of a rapid surge of patients, and should consider additional efficiencies built in to electronic triage systems. This study presents a framework for assessing the accuracy, triage time, and feasibility of digital technologies in live simulation training or actual MCIs.BolducC, MaghrabyN, FokP, LuongTM, HomierV. Comparison of electronic versus manual mass-casualty incident triage. Prehosp Disaster Med. 2018;33(3):273–278.

Inadequate Mass-Casualty Knowledge Base Adversely Affects Treatment Decisions by Trauma Care Providers: Survey on Hospital Response following a Terrorist Bombing

2009 ◽  
Vol 24 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Itamar Ashkenazi ◽  
Oded Olsha ◽  
William P. Schecter ◽  
Boris Kessel ◽  
Tawfik Khashan ◽  
...  
Keyword(s):  
Knowledge Base ◽  
Trauma Care ◽  
Critical Evaluation ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Further Education ◽  
Emergency Medical Technicians ◽  
Care Providers ◽  
Hospital Response ◽  
Terrorist Bombing

AbstractHealthcare professionals require a unique knowledge base to function effectively during a hospital's response to a mass-casualty incident (MCI). A survey of 128 physicians, nurses, and emergency medical technicians involved in trauma care was conducted to assess their knowledge base and how it affected their decision-making in response to a MCI following a terrorist bombing. Three-quarters of the study group responded that ≥20% of the surviving victims were critically injured. Only half of the responders indicated that the main objective of medical management is identifying and treating patients with critical injuries. Forty percent of responders indicated that they would not triage a critically injured victim to immediate care. This survey indicates that further education in the principles of MCI management should be based on critical evaluation of the literature.

Evaluation of the Risk of Therapy-Associated Complications in Survivors of Hodgkin Lymphoma

Hematology ◽  
2007 ◽  
Vol 2007 (1) ◽  
pp. 192-196 ◽  
Author(s):  
Lois B. Travis
Keyword(s):  
Hodgkin Lymphoma ◽  
Health Care Providers ◽  
Late Effects ◽  
Disease Risk ◽  
Risk Measures ◽  
Epidemiologic Study ◽  
Incidence Rates ◽  
Care Providers ◽  
Large Numbers ◽  
Study Designs

Abstract Given the improvements in survival of patients with Hodgkin lymphoma (HL) in the last three decades, quantification of the late effects of successful treatment has become critical. Since the highest incidence rates of HL occur at ages 20 to 34 years, large numbers of patients remain at lifelong risk for the late effects of treatment. Deaths due to second cancers are now the most common cause of mortality among long-term survivors of HL, followed by cardiac disease. Risk measures of these and other late sequelae, however, can vary markedly between investigations, depending on the types of treatment, the rigor with which epidemiologic study designs are applied, ascertainment of events of interest, the duration and completeness of follow-up, and consideration of competing risks. Further, numerous influences apart from therapy can affect late effects, including patient age, sex, race, lifestyle factors (tobacco, alcohol, diet), comorbidities, and the underlying cancer process. In the future, it will become increasingly important for health-care providers to be able to critically evaluate the risk of late effects in HL survivors, which will include a working knowledge of various epidemiologic study designs and risk measures and an ability to judiciously review the medical literature. In this article, the methods, significance and caveats in calculating and reporting risks of complications of treatment for HL are reviewed.

scholarly journals Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

2016 ◽  
Vol 89 (1061) ◽  
pp. 20150984 ◽  
Author(s):  
Ferco H Berger ◽  
Markus Körner ◽  
Mark P Bernstein ◽  
Aaron D Sodickson ◽  
Ludo F Beenen ◽  
...  
Keyword(s):  
Disaster Management ◽  
Mass Casualty Incident ◽  
Management Plan ◽  
Mass Casualty ◽  
Radiology Department ◽  
Emergency Imaging

Comparison of Outcome Tools Used to Test Mass-Casualty Algorithms in the Pediatric Population

2021 ◽  
pp. 1-5
Author(s):  
J. Joelle Donofrio ◽  
Alaa Shaban ◽  
Amy H. Kaji ◽  
Genevieve Santillanes ◽  
Mark X. Cicero ◽  
...  
Keyword(s):  
Injury Severity ◽  
Pediatric Population ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Study Objective ◽  
Large Numbers ◽  
Triage Category ◽  
Level I ◽  
Outcome Tool ◽  
Trauma Activation

Abstract Introduction: Mass-casualty incident (MCI) algorithms are used to sort large numbers of patients rapidly into four basic categories based on severity. To date, there is no consensus on the best method to test the accuracy of an MCI algorithm in the pediatric population, nor on the agreement between different tools designed for this purpose. Study Objective: This study is to compare agreement between the Criteria Outcomes Tool (COT) to previously published outcomes tools in assessing the triage category applied to a simulated set of pediatric MCI patients. Methods: An MCI triage category (black, red, yellow, and green) was applied to patients from a pre-collected retrospective cohort of pediatric patients under 14 years of age brought in as a trauma activation to a Level I trauma center from July 2010 through November 2013 using each of the following outcome measures: COT, modified Baxt score, modified Baxt combined with mortality and/or length-of-stay (LOS), ambulatory status, mortality alone, and Injury Severity Score (ISS). Descriptive statistics were applied to determine agreement between tools. Results: A total of 247 patients were included, ranging from 25 days to 13 years of age. The outcome of mortality had 100% agreement with the COT black. The “modified Baxt positive and alive” outcome had the highest agreement with COT red (65%). All yellow outcomes had 47%-53% agreement with COT yellow. “Modified Baxt negative and <24 hours LOS” had the highest agreement with the COT green at 89%. Conclusions: Assessment of algorithms for triaging pediatric MCI patients is complicated by the lack of a gold standard outcome tool and variability between existing measures.

Will Emergency Health Care Providers Respond to Mass Casualty Incidents?

2007 ◽  
Vol 11 (1) ◽  
pp. 49-54 ◽  
Author(s):  
James I. Syrett ◽  
John G Benitez ◽  
William H. Livingston ◽  
Eric A. Davis
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Care Providers ◽  
Emergency Health Care

The Importance of Preparedness for Emergency Response to Railway Incidents

2017 ◽  
Author(s):  
John Cockle ◽  
Larry Day
Keyword(s):  
Public Transportation ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Mass Casualties ◽  
Shared Resources ◽  
Use Of Time ◽  
Mass Casualty Events ◽  
Large Numbers ◽  
Time And Energy ◽  
Large Groups

Public transportation provides opportunities for people to share a common platform or mode of transportation as they move from place to place, often amassing persons in large groups or quantities. Rail transportation in particular has the benefit of accommodating very large numbers of people in one movement, often upwards of 1000 persons. The benefits to society are considerable: shared resources, lower impacts on the environment, and more efficient use of time and energy. The consequence when something goes wrong, however, can also be considerable: mass casualties (fatalities and/or injuries) from a single event, disrupted supply chains, and environmental damages to name a few. Even if persons are not physically harmed, the effects of an incident can be felt by a far greater number of persons. Adequate preparation can play a key role in minimizing the effects of mass casualty events such as railway collisions or derailments. Indeed, lives can be saved or lost depending on the resources, training, and organization that are employed when responding to a mass casualty incident.

scholarly journals A refinement of clinical tumour marker monitoring - why not use an inverse value of doubling time?

2021 ◽  
Author(s):  
Gintaras Zaleskis ◽  
Paulius Bosas ◽  
Albertas Ulys ◽  
Daiva Dabkevičiene ◽  
Neringa Dobrovolskiene ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Doubling Time ◽  
Specific Antigen ◽  
Elimination Rate ◽  
Life Time ◽  
Tumour Marker ◽  
Growth Fraction ◽  
Care Providers ◽  
Primary Health Care Providers ◽  
Large Numbers

The aim of this study was to compare prostate specific antigen (PSA) kinetics – half life time (HT), doubling time (DT) and elimination rate PSA (ePSA) in prostate cancer monitoring. We report that implementation of inverse value (ePSA) rather than HT or DT has distinct advantages: (1) values are valid when PSA is unchanged (ePSA equals zero), (2) the concept of ePSA is easily comprehendible – it is a growth fraction, (3) ePSA fluctuates in a narrow range – easy to interpret, no large numbers, (4) no mathematical flaws (no positive skewing). Exploring ePSA norm as < 0% might help to timely spot a biochemical recurrence (BCR). Primary health care providers (PHCP) tend to habitually use an irrelevant PSA threshold – 4.0 ng/ml in postoperative follow-up. The delayed referrals of patients in remission might be reduced if PHCPs adopt an ePSA.

Extending injury prevention methodology to chemical terrorism preparedness: The Haddon Matrix and sarin

2006 ◽  
Vol 1 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Shawn Varney, Lt. Col., USAF, MC ◽  
Jon Mark Hirshon, MD, MPH ◽  
Patricia Dischinger, PhD ◽  
Colin Mackenzie, MD
Keyword(s):  
Injury Prevention ◽  
Health Care Providers ◽  
Mass Casualty ◽  
Mass Casualties ◽  
Care Providers ◽  
Terrorism Preparedness ◽  
Chemical Terrorism ◽  
The Individual ◽  
City State ◽  
Haddon Matrix

The Haddon Matrix offers a classic epidemiologi¬cal model for studying injury prevention. This method-ology places the pudlic health concepts of agent, host, and environment within the three sequential phases of an injury-producing incident—pre-event, event, and postevent. This study uses this methodology to illus-trate how it could de applied in systematically prepar-ing for a mass casualty disaster such as an unconven-tional sarin attack in a major urdan setting. Nineteen city, state, federal, and military agencies responded to the Haddon Matrix chemical terrorism preparedness exercise and offered feeddack in the data review ses-sion. Four injury prevention strategies (education, engineering, enforcement, and economics) were applied to the individual factors and event phases of the Haddon Matrix. The majority of factors identified in all phases were modifiadle, primarily through edu-cational interventions focused on individual health-care providers and first responders.  The Haddon Matrix provides a viadle means of studying an unconventional prodlem, allowing for the identification of modifiadle factors to decrease the type and severity of injuries following a mass casualty dis-aster such as a sarin release. This strategy could de successfully incorporated into disaster planning for other weapons attacks that could potentially cause mass casualties.

scholarly journals The Significance of Witness Sensors for Mass Casualty Incidents and Epidemic Outbreaks (Preprint)

2017 ◽  
Author(s):  
Chih-Long Pan ◽  
Chih-Hao Lin ◽  
Yan-Ren Lin ◽  
Hsin-Yu Wen ◽  
Jet-Chau Wen
Keyword(s):  
Health Care ◽  
Social Media ◽  
Health Care Providers ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Accurate Information ◽  
Care Providers ◽  
Innovative Strategies ◽  
Media Messages ◽  
Novel Concept

UNSTRUCTURED Due to the increasing number of natural and man-made disasters, mass casualty incidents occur more often than ever before. As a result, health care providers need to adapt in order to cope with the overwhelming patient surge. To ensure quality and safety in health care, accurate information in pandemic disease control, death reduction, and health quality promotion should be highlighted. However, obtaining precise information in real time is an enormous challenge to all researchers of the field. In this paper, innovative strategies are presented to develop a sound information network using the concept of “witness sensors.” To overcome the reliability and quality limitations of information obtained through social media, researchers must focus on developing solutions that secure the authenticity of social media messages, especially for matters related to health. To address this challenge, we introduce a novel concept based on the two elements of “witness” and “sensor.” Witness sensors can be key players designated to minimize limitations to quality of information and to distinguish fact from fiction during critical events. In order to enhance health communication practices and deliver valid information to end users, the education and management of witness sensors should be further investigated, especially for implementation during mass casualty incidents and epidemic outbreaks.

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